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Chapter 48
Herbal and Dietary Supplement Therapy
Learning Objectives
Describe the possible impact of the use of herbal and dietary supplement products on
cultural/ethnic beliefs
Summarize the primary actions, uses, and interactions of the herbal and dietary
supplement products cited
Herbal and Dietary Supplements
“All natural” is NOT synonymous with “better”
Some herbal medicines/supplements are harmful
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Drug interactions
DSHEA
Dietary Supplement Health and Education Act of 1994
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Side effects
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Almost all herbal medicines, vitamins, minerals, amino acids for health reclassified
as “dietary supplements,” a food category
Allows manufacturers to include information about effects on body on the label and
in advertisements
Must state that product is not evaluated by FDA
Does not stop others from making claims
Safe and Effective?
No safety, effectiveness requirements
Vast majority of claims are unproven
No standardized manufacturing requirements
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Several organizations test for labeled potency, good manufacturing practices, and
contamination—not safety or effectiveness
Label Certification
Role of Health Care Professional
Moral, ethical responsibility to recommend only medicines proven to be safe and effective
Factors to consider
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Most supplements have not been scientifically tested
Consumers may be misinformed
Supplements cannot cure serious conditions
Quality control is deficient
Exercise caution for pregnant or pediatric patients
Watch for side effects
Examine label carefully
Assessment
Discuss patient’s reasons for interest and/or use
Obtain list of patient symptoms and information about changes in symptoms since
supplement use
Find out source of recommendation
Obtain complete list of all medications
Determine cultural/ethical beliefs contributing to supplement use decision
Planning
History of symptoms
Medication history
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History and physical assessment
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Hospital policy regarding administration and reporting of products
Cultural/ethnic beliefs
Implementation
Perform detailed assessments of symptoms and side effects
Record data in nursing notes
Label front of chart with list of supplements in use
Discuss cultural and ethnic beliefs with patient
Patient Education
Expectations of therapy
Discuss medication information
Ensure understanding of proper use
Promote the development and maintenance of a written record of monitoring parameters
Herbal Therapy
Aloe
Black cohosh
Chamomile
Echinacea
Ephedra
Feverfew
Garlic
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Ginger
Learning Objectives
Summarize the primary actions, uses, and interactions of the herbal and dietary
supplement products cited
Herbal Therapy
Ginkgo
Ginseng
Goldenseal
Green tea
Saw palmetto
St. John’s wort
Valerian
Other Dietary Supplements
Coenzyme Q10
Creatine
Gamma-hydroxybutyrate (GHB)
Lycopene
Melatonin
Policosanol
S-adenosylmethionine (SAM-e)